King's Daughters Medical Center: Community Rotation, Weeks 1 & 2

Starting at a new rotation can always be scary, but two weeks in and I already feel at home here at King’s Daughters Medical Center. I am currently with the surgical weight loss team, who also specializes in non-surgical weight loss and diabetes counseling. The team has been extremely helpful and welcoming to me. Being the only guy in a team that consists of all females has been a fun experience already, and they like giving me a hard time, but it’s been fine because I have no issues returning the favor. ;)

During the first week, it consisted of me shadowing the dietitians and sitting in on their sessions with patients. For the most part, I didn’t really say much until I was more comfortable with the dietitian I was working with and after I figured out the “flow” of how each of their sessions would typically go. Then, once I was comfortable, I would slowly start to chime in a little more during the counseling sessions when I thought I could add to the information the dietitian was providing. It worked out well because we could bounce ideas and suggestions off one another to help the patient better reach their intended outcome. It was also neat because my preceptor and I got to discuss some critical thinking questions once the patient had left, which usually resulted in digging through some scientific research to gain some clarity on our discussion. I feel like the current body of literature is constantly evolving, so this is a competency I would like to work on -- CRDN 1.4 Evaluate emerging research for application in nutrition and dietetics practice. One research meta-analysis I ended up looking at was by Cheng et al. (2017), who looked at the comprehensive summary of surgical versus non-surgical treatment for obesity. The pooled results of primary endpoints (weight loss and diabetic remission) revealed a significant advantage among surgical patients rather than those receiving non-surgical treatments (P < 0.05). Furthermore, except for certain cardiovascular indicators, bariatric surgery was superior to conventional arms in terms of metabolic secondary parameters (P < 0.05).

Towards the end of the first week, my preceptor and I got to sit down and plan out my goals and what I could possibly experience while I was working here.  We were able to fill out my competency fulfillment plan and make sure I knew exactly what I was doing while I am at the facility. I felt like this is a competency I did well on because I am very open to new experiences and communicating what shortcomings I believe I have at the moment that could be improved on while I’m here at KDMC-- CRDN 2.12 Perform self-assessment and develop goals of self-improvement throughout the program.

I have really enjoyed trying to keep up with everything the dietitians tell their patients, because a lot of it is new information for me to learn as well. Specifically, a lot of the information on diabetes patients was new to me. I have a general understanding of diabetes and how it works, but in these sessions we get into the nitty-gritty details of how to time your insulin, where to inject it, when to eat, how many times to eat, etc. For one patient, I got to sit in on their session with the nurse and with the dietitian so I could follow along with them through the counseling experience.

Finally, the last activity I got to experience was sitting in on the behavioral health class for the pre-operation patients about to forego bariatric surgery. This class covered all the mental health aspects of how the bariatric surgery will impact your life. Some topics discussed included dealing with friends and family around the surgery, dealing with emotional hunger, hormones, learning healthy behaviors, etc. I am very interested in the psychological side of obesity and it’s been fun for me to witness first-hand what is going on inside the mind of these patients living through it.

The first two weeks have been a complete success and I’ve already learned so much when it comes to an outpatient setting. I couldn’t ask for a better team and better environment, so I’m excited for the weeks ahead. 

  Just a candid shot of me working SUPER hard.

Just a candid shot of me working SUPER hard.


References

1. Cheng, J., Gao, J., Shuai, X., Wang, G., & Tao, K. (2016). The comprehensive summary of surgical versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomized controlled trials. Oncotarget, 7(26), 39216–39230.